Updates on Laparoscopy Versus Laparotomy in the Management of Penetrating Abdominal Trauma: A Systematic Review

The purpose of this review is to contrast laparotomy with laparoscopy for penetrating abdominal trauma (PAT) in terms of efficacy, safety, and patient outcomes. A thorough search across four databases identified 416 relevant publications. After removing duplicates using Rayyan Qatar Computing Research Institute (QCRI) and screening for relevance, 36 full-text articles were reviewed, with five studies ultimately meeting the criteria for inclusion. There were 336 patients throughout five trials, with 273 (812%) of them being male. In total, 211 patients had laparoscopy, whereas 125 underwent laparotomy. From 2.9% to 17.9%, there was a conversion rate from laparoscopic to open approach. The review highlights that laparoscopy generally results in fewer complications compared to laparotomy, especially in stable individuals who have experienced piercing abdominal trauma. Laparoscopy is associated with shorter hospital stays, faster recovery, and fewer postoperative issues such as wound infections. However, in cases of retroperitoneal injuries or active bleeding, higher conversion rates to open surgery were observed. Despite these limitations, laparoscopy proves to be an effective and less invasive option for managing selected cases of abdominal trauma, reducing overall healthcare costs and postoperative morbidity. Laparoscopy offers a minimally invasive, practical choice for treating piercing abdominal injuries, especially in stable patients, with fewer postoperative complications and faster recovery compared to laparotomy. However, its limitations in managing more complex injuries warrant careful patient selection and readiness to convert to open surgery when necessary. It will take more investigation, especially randomized studies, to confirm laparoscopy's place in this sector.